开胸手术两种不同麻醉与镇痛方法的效果比较

A COMPARISON OF TWO ANESTHETIC AND ANALGESIA METHODS IN PATIENTS UNDERGOING THORACIC SURGERY

目的 :比较开胸手术下两种不同麻醉与镇痛方法的效果。方法 :将 10 0例病人随机分成 2组 ,Ⅰ组 60例 ,采用全麻 -硬膜外联合麻醉 ,术中维持用异丙酚 2～ 4mg/ (kg·h)微泵静滴及硬膜外追加 1 2 %利多卡因、0 15 %丁卡因 ,必要时按需吸入少量异氟醚 ,术后行硬膜外镇痛。Ⅱ组 40例 ,采用静吸复合全麻 ,术中维持用异丙酚 2～ 6mg/ (kg·h)及吸入异氟醚维持 ,术后行静脉镇痛。分别监测两组病人麻醉前、插管即刻、去肋开胸、手术探查、拔管时的SBP、DBP、HR ,术后清醒时间、术毕躁动及术后镇痛效果情况。结果 :Ⅰ组病人麻醉及手术过程中 ,BP、HR平稳 ,术后患者苏醒快 ,苏醒质量及术后镇痛效果佳 ;Ⅱ组病人BP、HR波动较大 ,且患者苏醒相对缓慢 ,苏醒质量及术后镇痛效果相对欠佳。结论 :全麻

Objective:To compare the effects of two anesthetic and analgesia methods in patients undergoing thoracic surgery.Method:100 patients were divided into two groups:60 patients in Group I received combined general epidural anesthesia,followed by intravenous infusion of propofol 2～4 mg/(kg·h) and 1.2% lidocaine as well as 0.15% dicaine through epidural administration.Isoflurane was inhaled if necessary after intubation.40 patients in Group Ⅱ received complex anesthesia of intravenous drip and inhalation ,infusion of propofol 2～6 ml/(kg·h) and inhalation of isoflurane.SBP?DBP?HR and the time of consciousness recovery as well as restlessness,effect of analgesia were recorded before and after intubation and anesthesia.Results:Patients in Groupt I had stable MAP and HR than that in GrouptⅡ,recovery of consciousness in Group Ⅰ was quicker and better in quality as well as effect of analgesia than that in Groupt Ⅱ.Conclusion:The effect of anesthetic and analgesia method of Group Ⅰ is much better than that in Group Ⅱ?